Dr. Smith's ECG Blog

JULY 31, 2018

A pathognomonic ECG you should recognize instantly Bupropion Overdose Followed by Cardiac Arrest and, Syncope in a 20-something woman His bundle pacing A man in his 40s with chest pain Is there a Right Ventricular MI in addition to Inf. Chest pain and T-wave inversion in lead V2 Prehospital OMI recognized immediately by a fantas.

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STEMI Coronary CPR ACS 52

The Skeptics' Guide to EM

SEPTEMBER 21, 2024

You and your partner initiate high-quality CPR, place a supraglottic airway, establish intra-osseous (IO) access and administer epinephrine. Naloxone is a well-established medication used primarily for reversing opioid overdoses. There is drug paraphernalia scattered around the room. Today’s study looks at the role of naloxone in OHCA.

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Naloxone NARCAN Overdose CPR 259

Dr. Smith's ECG Blog

JULY 25, 2024

After 1 mg of epinephrine they achieved ROSC. Total prehospital meds were epinephrine 1 mg x 3, amiodarone 300 mg and 100 mL of 8.4% EMS arrived and found him in Ventricular Fibrillation (VF). He was defibrillated into VT. He then underwent dual sequential defibrillation into asystole. sodium bicarbonate.

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Defibrillator Coronary ACS Epinephrine 131

Pediatric EM Morsels

OCTOBER 27, 2023

Broselow-Luten System: Supportive Data Physician estimates of weight can underdose children by 49% or overdose by up to 116%. Reduces dosing errors during resus, up to 33.88%. Recommended by ATLS and PALS. Krug 2007] What If the Child is Obese or Emaciated? There are other systems that account for body habitus.

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E-9-1-1 Emergency Medical Services Life Support ALS 274

EMDocs

JANUARY 23, 2024

. #2: Treat bradycardia Calcium: 1 g calcium chloride or 3 g calcium gluconate IV; redosing is often necessary Epinephrine: 5-10 mcg/minute Will improve heart rate and shift potassium intracellularly If still unstable after calcium and epinephrine, pacing will be needed Skip atropine #3: Treat hyperkalemia If thinking BRASH, start hyperkalemia treatment (..)

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Epinephrine Overdose OR 101

EMDocs

JANUARY 8, 2024

Calcium is associated with harm but is still necessary in certain situations (hyperkalemia, calcium channel blocker overdose) (Level 3 recommendation: no benefit). Vasopressor medications during cardiac arrest We recommend that epinephrine be administered for patients in cardiac arrest. COR 1, LOE B-R. COR 2a, LOE B-R. COR 2b, LOE B-R.

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Epinephrine Defibrillator Coronary CPR 98

Emergency Medicine Cases

APRIL 20, 2021

AV nodal blocker overdose? What are the latest recommendations about dosing of atropine and when is atropine likely to be detrimental? How is the treatment of bradycardia different in the patient with hypothermia? Cardiac ischemia? Myxedema coma? What are the most common pitfalls in utilizing transcutaneous and transvenous pacing?

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Overdose EMS Epinephrine 130

EMDocs

APRIL 10, 2024

1,2] Consider using a physiological marker to help identify inadvertent vascular injection, such as epinephrine. [3] If epinephrine is used, small initial doses ( <1 ug/kg) are preferred. Poisoning & Drug Overdose. Epidemiology Most common cause: inadvertent intravascular injection. Vasopressin is not recommended.

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E-9-1-1 Plasma Epinephrine ED 104

REBEL EM

SEPTEMBER 1, 2022

Although the results of both the short and long-term outcomes of the COCA trial do not support the use of calcium in all patients with OHCA, there are some populations that may still benefit from this treatment including patients with hyperkalemia, hypocalcemia, and calcium channel blocker overdose. Placebo: 9.1% RR 0.51; 95% CI 0.24

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Epinephrine Overdose ALS OR 52

Peter Canning

JANUARY 14, 2024

The pediatric epinephrine and norepinephrine infusion rates have been lowered to 0.1-0.5 AEMTs may administer epinephrine IV in cardiac arrest.* Sodium bicarbonate should only be administered in cardiac arrest for suspected sodium channel blocker overdoses. micrograms/kg/min. EMTs may administer 0.3

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CPR Naloxone AEMT Defibrillator 52

Dr. Smith's ECG Blog

FEBRUARY 8, 2015

Common culprits in this situation are tricyclic overdose and cocaine toxicity (remember cocaine not only increases dopamine in central synapses, but is also a local anesthetic (-caine!) Esmolol in the management of epinephrine- and cocaine-induced cardiovascular toxicity. due to Na channel blockade. Both of these also cause seizures.

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E-9-1-1 Coronary Epinephrine Overdose 52

NCOAE

NOVEMBER 13, 2021

Depending on the state, EMTs are authorized to administer 10 to 20 different medications, including epinephrine for an anaphylactic reaction, narcan for an overdose, or albuterol for an asthma attack. Basic anatomy and physiology, what causes common diseases like diabetes and asthma, and how to treat emergencies associated with them.

EMT 52

EMT EMT Emergency Medical Technician Ambulance Driver 52

NAEMSP

APRIL 19, 2023

After several cycles of defibrillation, epinephrine, and amiodarone, the patient remains in cardiac arrest. Special causes of cardiac arrest to include hyperkalemia and calcium channel blocker overdose, have limited data regarding efficacy but do still carry the recommendation for calcium administration. References: 1. Ramazan, K.,

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E-9-1-1 Advanced Life Support Overdose Defibrillator 52

Dr. Smith's ECG Blog

APRIL 29, 2020

She was given 3 mg IV epinephrine and multiple rounds of ACLS over approximately 20 minutes. This is commonly found after epinephrine for cardiac arrest, but could have been pre-existing and a possible contributing factor to cardiac arrest. A 60-something woman presented after a witnessed cardiac arrest. CPR was started immediately.

Defibrillator 52

Defibrillator Epinephrine Coronary Overdose 52

Core EM

JANUARY 25, 2024

Background: An update to our 2015 post on HIET for beta-adrenergic receptor and calcium channel antagonists overdose. Beta-adrenergic receptor antagonists (Beta blockers, BB) and calcium channel antagonists (calcium channel blockers) are common drugs that can produce profound cardiac depression and shock when taken in overdose.

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Overdose ALS Epinephrine ICU 247

REBEL EM

DECEMBER 19, 2022

trying harder and longer knowing they are enrolled in this study) Use of two different models of defibrillators may negatively impact the internal validity of this pilot study Certain baseline characteristics were not balanced, such as: prehospital intubation and Epinephrine administration.

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Defibrillator Paramedic CPR EMS 52

ALiEM

NOVEMBER 29, 2023

Recently, xylazine has gained attention in the media with increasing reports of xylazine-related overdose deaths in patients. When combined with illicit opioids such as heroin and fentanyl, xylazine may increase the risk of fatal overdose given the augmented sedation and respiratory depression effects [2]. Published May 2023.

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Naloxone Overdose ALS Epinephrine 169

EMDocs

JANUARY 4, 2024

Questions: What are the clinical manifestations of bupropion overdose? How is bupropion overdose treated? How long should a patient be observed after a bupropion overdose? 1 In addition to intentional overdoses, there are multiple case studies of abuse (ingestion, insufflation, injection). hours, SR 3 hours, XL 5 hours.

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Overdose E-9-1-1 ALS Emergency Department 89

REBEL EM

JUNE 12, 2024

According to the 2022 Annual Report of the National Poison Data System from America’s Poison Center, CCBs and BBs account for the sixth and seventh largest number of fatalities from overdose. Insulin versus vasopressin and epinephrine to treat beta-blocker toxicity. Circulation. 2005;111(20):2588-2595. doi:10.1161/CIRCULATIONAHA.104.497461

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Epinephrine Overdose ALS OR 92

EMDocs

JANUARY 16, 2024

The patient received 1 mg of epinephrine IV x2 with conversion of his rhythm to ventricular fibrillation (VF) for which he was defibrillated twice in the field. He requires low-dose epinephrine to maintain his mean arterial pressure (MAP) in the 60s mmHg and is transported to the cardiothoracic (CT) ICU.

Defibrillator 101

Defibrillator CPR Epinephrine Life Support 101

Dr. Smith's ECG Blog

JULY 21, 2024

Epinephrine infusion was begun. These are also the most commonly reported findings in toxic overdoses with ventricular arrhythmias being reported as the leading cause of death. You can see Left Main and Proximal LAD obstruction, but with some flow, which is saving this patient's life. Subsequent PCI of the LMCA and LAD was performed.

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Defibrillator Coronary ALS STEMI 137

EM Board Bombs

MARCH 13, 2025

-Case- EMS brings in a 52-year-old man found unresponsive at home with an empty bottle of an unknown medication nearby. His wife reports he had been complaining of dizziness and weakness earlier in the day. On arrival, Tom is bradycardic at 38 bpm, hypotensive at 75/40 mmHg, and minimally responsive.

Overdose 52

Overdose ED EMS Epinephrine 52

EMDocs

JANUARY 22, 2025

Background: Fentanyl has contributed to a significant increase in drug overdose deaths in recent years. A prospective study of 453 patients who were admitted after receiving naloxone reported life-threatening complications in over 1% of heroin-overdosed patients. Clinical Pearls: Naloxone is lifesaving in opioid overdoses.

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Naloxone E-9-1-1 Overdose ALS 94

EMDocs

JUNE 4, 2025

7 Clinical Presentation and Diagnosis: 8-10 Pyrethrin and pyrethroid overdoses present similarly and may present concurrently as these active ingredients are often combined in pesticide treatments. Use IM or IV anaphylaxis dosing of epinephrine, antihistamines, steroids, and inhaled beta-agonists as warranted.

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E-9-1-1 ALS EMS Epinephrine 100